Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial

BackgroundPerformance anxiety represents a significant challenge for students, manifesting as a fear of failure and difficulties managing examination-related concerns and academic pressures. According to recent statistics, anxiety affects >4% of the global population, unde...

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Main Authors: Cristina Maria Tofan, Liviu-Adrian Măgurianu, Magdalena Axinte, Alexandra Maria Găină, Marcel Găină
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2025/1/e66112
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author Cristina Maria Tofan
Liviu-Adrian Măgurianu
Magdalena Axinte
Alexandra Maria Găină
Marcel Găină
author_facet Cristina Maria Tofan
Liviu-Adrian Măgurianu
Magdalena Axinte
Alexandra Maria Găină
Marcel Găină
author_sort Cristina Maria Tofan
collection DOAJ
description BackgroundPerformance anxiety represents a significant challenge for students, manifesting as a fear of failure and difficulties managing examination-related concerns and academic pressures. According to recent statistics, anxiety affects >4% of the global population, underscoring the need for effective management methods. Studies indicate that yoga and virtual reality (VR) training can alleviate symptoms of performance anxiety. ObjectiveThis trial aims to compare VR-assisted cognitive behavioral therapy (CBT) with yoga interventions to find effective treatments. MethodsA single-blinded randomized controlled trial will be conducted with 60 participants (n=30, 50% per intervention group) recruited from university and preuniversity counseling centers. The trial will measure whether the interventions reduce performance anxiety in students. Stratified randomization will be used to ensure equal distribution of baseline anxiety levels and gender across both groups. The primary outcome is a reduction in anxiety, measured using the State-Trait Anxiety Inventory-Y1 and State-Trait Anxiety Inventory-Y2 subscales. Secondary outcomes include emotional regulation and quality of life. Data will be collected at baseline, after the intervention, and during follow-up assessments. Statistical analyses will include parametric tests (eg, repeated-measures ANOVA and t tests) to compare anxiety reduction, emotional regulation, and quality of life across groups. The intention-to-treat approach will be applied to minimize bias due to participant dropouts. Sensitivity analyses will assess the robustness of the findings. ResultsThis study is planned to start in September 2025 and end in June 2026. VR-assisted CBT is expected to reduce anxiety very quickly, whereas yoga is predicted to have long-term benefits. ConclusionsMore generally, this research highlights the need for new, accessible forms of mental health support. VR-assisted CBT is an emerging digital mental health intervention, and it enables individuals to access and explore anxiety in virtual, safe environments. In contrast, yoga is a more conventional, all-encompassing discipline that enhances mental health through physiological and psychological processes that may have long-term effects. Trial RegistrationClinicalTrials.gov NCT06639841; https://clinicaltrials.gov/study/NCT06639841 International Registered Report Identifier (IRRID)PRR1-10.2196/66112
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spelling doaj-art-de9c622b836a485c992012af158403602025-08-20T02:38:02ZengJMIR PublicationsJMIR Research Protocols1929-07482025-06-0114e6611210.2196/66112Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled TrialCristina Maria Tofanhttps://orcid.org/0000-0002-8733-725XLiviu-Adrian Măgurianuhttps://orcid.org/0009-0005-2590-0499Magdalena Axintehttps://orcid.org/0009-0005-0145-3612Alexandra Maria Găinăhttps://orcid.org/0009-0004-8374-4255Marcel Găinăhttps://orcid.org/0000-0003-0533-9014 BackgroundPerformance anxiety represents a significant challenge for students, manifesting as a fear of failure and difficulties managing examination-related concerns and academic pressures. According to recent statistics, anxiety affects >4% of the global population, underscoring the need for effective management methods. Studies indicate that yoga and virtual reality (VR) training can alleviate symptoms of performance anxiety. ObjectiveThis trial aims to compare VR-assisted cognitive behavioral therapy (CBT) with yoga interventions to find effective treatments. MethodsA single-blinded randomized controlled trial will be conducted with 60 participants (n=30, 50% per intervention group) recruited from university and preuniversity counseling centers. The trial will measure whether the interventions reduce performance anxiety in students. Stratified randomization will be used to ensure equal distribution of baseline anxiety levels and gender across both groups. The primary outcome is a reduction in anxiety, measured using the State-Trait Anxiety Inventory-Y1 and State-Trait Anxiety Inventory-Y2 subscales. Secondary outcomes include emotional regulation and quality of life. Data will be collected at baseline, after the intervention, and during follow-up assessments. Statistical analyses will include parametric tests (eg, repeated-measures ANOVA and t tests) to compare anxiety reduction, emotional regulation, and quality of life across groups. The intention-to-treat approach will be applied to minimize bias due to participant dropouts. Sensitivity analyses will assess the robustness of the findings. ResultsThis study is planned to start in September 2025 and end in June 2026. VR-assisted CBT is expected to reduce anxiety very quickly, whereas yoga is predicted to have long-term benefits. ConclusionsMore generally, this research highlights the need for new, accessible forms of mental health support. VR-assisted CBT is an emerging digital mental health intervention, and it enables individuals to access and explore anxiety in virtual, safe environments. In contrast, yoga is a more conventional, all-encompassing discipline that enhances mental health through physiological and psychological processes that may have long-term effects. Trial RegistrationClinicalTrials.gov NCT06639841; https://clinicaltrials.gov/study/NCT06639841 International Registered Report Identifier (IRRID)PRR1-10.2196/66112https://www.researchprotocols.org/2025/1/e66112
spellingShingle Cristina Maria Tofan
Liviu-Adrian Măgurianu
Magdalena Axinte
Alexandra Maria Găină
Marcel Găină
Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
JMIR Research Protocols
title Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
title_full Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
title_fullStr Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
title_full_unstemmed Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
title_short Comparative Efficacy of Virtual Reality–Assisted Cognitive Behavioral Therapy Versus Yoga-Based Interventions for Reducing Performance Anxiety in Students: Protocol for a Randomized Controlled Trial
title_sort comparative efficacy of virtual reality assisted cognitive behavioral therapy versus yoga based interventions for reducing performance anxiety in students protocol for a randomized controlled trial
url https://www.researchprotocols.org/2025/1/e66112
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